CMS Price Transparency Data

Total hip replacement

Facility: Tri-City Medical Center

Billing Code: 27130 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$15,206

about 1.2× the $13,117 Medicare rate · typically $4,885–$16,043

modeled estimate · not a bill or quote

What this hospital charges insurers

$16,513

About the fair price

about $1,307 over the fair price · 1.3× Medicare

Medicare pays $13,117 Fair price $15,206 This hospital $16,513

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

Highest price of the 9 CA hospitals we have prices for — worth calling around.

Cheapest $2,295 Priciest $16,513

Black dot = this hospital, among the 9 CA hospitals with a price for this procedure. Full list below.

A fair price for a Total hip replacement is about $15,206 (about 1.2× the $13,117 Medicare rate). Tri-City Medical Center charges insurers about $16,513 — about the fair price. Located in Oceanside, CA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana✓ Kaiser Permanente Cigna

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$16,513	126%
Blue Cross Blue Shieldmajor	$16,513	126%
Aetnamajor	$6,640 - $16,513	51%
Humanamajor	$16,513	126%
Kaiser Permanentemajor	$16,513	126%
Bright Health	$26,420	201%
Health Net	$1,504 - $26,090	11%
Molina	$16,513 - $22,292	126%
Providence Health Plan	$23,118	176%
+ 7 smaller / regional plans	$16,513 - $24,769

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 27130.

Insurance Before you use insurance

Call your insurance company to confirm Tri-City Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 27130.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Tri-City Medical Center

Compare: Total hip replacement at other CA hospitals

Clovis Community Medical Center · Clovis $2,295
Southwest Healthcare Rancho Springs Hospital · Murrieta $2,694
Valley Children's Hospital · Madera $2,991
Palmdale Regional Medical Center · Palmdale $3,833
Corona Regional Medical Center · Corona $3,851
Mercy Medical Center · Merced $5,819
Riverside Community Hospital · Riverside $5,892
Pomona Valley Hospital Medical Center · Pomona $6,405

Insurance negotiated median for the same procedure, sorted lowest first.